Matsushima Masashi, Kikuchi Eiji, Akita Hirotaka, Miyajima Akira, Oya Mototsugu, Jinzaki Masahiro
Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
Int J Clin Oncol. 2017 Jun;22(3):554-562. doi: 10.1007/s10147-017-1096-z. Epub 2017 Feb 10.
Detailed information is not currently available on the incidence, natural course, and management of asymptomatic abnormal prostate findings incidentally detected by radiologic evaluations after BCG therapy for non-muscle-invasive bladder cancer patients.
We identified 38 patients who were evaluated by contrast-enhanced CT scans before TUR-BT and after BCG therapy between 2006 and 2012. We evaluated the clinical courses of patients with abnormal radiologic findings of the prostate gland after BCG therapy.
Abnormal findings on CT scans were found in the prostate glands of 11 of the 38 patients examined (28.9%), none of whom exhibited any sign or symptom associated with prostatitis. Abnormal findings included a low attenuation area (n = 6, 15.8%), contrast enhancement (n = 3, 7.9%), and a low attenuation area and contrast enhancement in the prostate gland (n = 2, 5.3%). During the follow-up, abnormal prostate findings disappeared spontaneously in most cases without any anti-bacterial or anti-tuberculous drug treatments. No significant differences were observed in patient clinical backgrounds, with the exception of post-BCG prostate volumes, between patients with and without abnormal CT findings. Furthermore, no significant differences were noted in the incidence of the adverse effects of BCG therapy, tumor recurrence rates, or progression rates between patients with and without abnormal CT findings of the prostate gland after BCG therapy.
Asymptomatic abnormal prostate findings incidentally detected by CT after BCG therapy are not rare, and these disappear over time during the follow-up period without any treatment.
目前尚无关于非肌层浸润性膀胱癌患者接受卡介苗（BCG）治疗后，经放射学评估偶然发现的无症状前列腺异常的发生率、自然病程及处理的详细信息。
我们确定了38例在2006年至2012年间接受经尿道膀胱肿瘤电切术（TUR-BT）前及卡介苗治疗后的患者，这些患者均接受了增强CT扫描。我们评估了卡介苗治疗后前列腺放射学异常患者的临床病程。
在38例接受检查的患者中，11例（28.9%）前列腺在CT扫描中发现异常，其中无一例表现出与前列腺炎相关的任何体征或症状。异常表现包括低密度区（n = 6，15.8%）、强化（n = 3，7.9%）以及前列腺内低密度区和强化（n = 2，5.3%）。在随访期间，大多数情况下前列腺异常表现无需任何抗菌或抗结核药物治疗即可自发消失。有和无CT异常表现的患者，除卡介苗治疗后的前列腺体积外，其临床背景无显著差异。此外，卡介苗治疗后有和无前列腺CT异常表现的患者，在卡介苗治疗不良反应发生率、肿瘤复发率或进展率方面均未观察到显著差异。
卡介苗治疗后经CT偶然发现的无症状前列腺异常并不罕见，且在随访期间会随时间自行消失，无需任何治疗。
